口服抗凝剂（达比加群）导致广泛自发性颈段硬膜外血肿，仅用逆转剂依达赛珠单抗成功治疗。
Extensive spontaneous cervical epidural hematoma due to oral anticoagulant (dabigatran) successfully treated with reversal agent idarucizumab alone.
作者信息
Uddin Syed-Abdullah, Roma Katerina, Ross Lindsey, Hanna George, Drazin Doniel, Kim Terrence T
机构信息
Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California.
Department of Neurosurgery, Pacific Northwest University of Health Sciences, Yakima, Washington.
出版信息
Surg Neurol Int. 2022 Jun 23;13:259. doi: 10.25259/SNI_929_2021. eCollection 2022.
BACKGROUND
Dabigatran is an anticoagulant (novel oral anticoagulant) that is a direct thrombin inhibitor and only recently has a reversal agent, idarucizumab, been made available (2015).
CASE DESCRIPTION
An 86-year-old male taking dabigatran for atrial fibrillation, acutely presented with the spontaneous onset of neck pain and quadriparesis. When the MRI demonstrated a C2-T2 spinal epidural hematoma, the patient was given the reversal agent idarucizumab. Due to his attendant major comorbidities, he was managed nonoperatively. Over the next 7 days, the patient's neurological deficits resolved, and within 2 weeks, he had regained normal neurological function.
CONCLUSION
In this case, a C2-T2 epidural cervical hematoma attributed to dabigatran that was responsible for an acute, spontaneous quadriparesis was successfully treated with the reversal agent idarucizumab without surgical intervention being warranted.
背景
达比加群是一种抗凝剂（新型口服抗凝剂），属于直接凝血酶抑制剂，直到最近（2015年）才有了逆转剂——艾达司珠单抗。
病例描述
一名86岁男性因心房颤动服用达比加群，突然出现颈部疼痛和四肢瘫。当磁共振成像显示C2 - T2脊髓硬膜外血肿时，给予患者逆转剂艾达司珠单抗。由于他伴有严重的合并症，故采取非手术治疗。在接下来的7天里，患者的神经功能缺损得到缓解，2周内恢复了正常神经功能。
结论
在本病例中，由达比加群引起的C2 - T2硬膜外颈部血肿导致急性、自发性四肢瘫，使用逆转剂艾达司珠单抗成功治疗，无需进行手术干预。
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